카바페넴분해효소 생성 장내세균속균종(CPE)이 획득된 내과계 중환자실 환자의 생존 영향 요인

Abstract

Purpose: Carbapenemase-producing Enterobacteriaceae (CPE) are associated with considerable mortality. This study was aimed to identify survival factors among medical care unit patients with CPE. Methods: We conducted a retrospective cohort; data were collected from September 2017 to June 2019 through electronic medical records. The data collected were general characteristics, disease-related characteristics, severity-related characteristics, and treatment-related characteristics. Data were analyzed based on frequency, mean, standard deviation, Chi-square test, Fisher’s exact test, t-test, Pearson’s correlation coefficient, and Cox proportional hazard model using SPSS/WIN 21.0 program. Results: Seventy-seven patients were included (59 survivors and 18 deceased) in the study. Univariate analysis identified factors for survival associated with acquired CPE as age (t=-1.56, p=.037), simplified acute physiology 3 (SAPS3) score of admission date (t=-2.85, p=.006), Glasgow coma scale (GCS) of CPE acquisition date (t=2.38, p=.020), artery catheter at CPE acquisition date (χ2=4.58, p=.032), vasoconstrictor agents use at CPE acquisition date (χ2=6.81, p=.009), platelet at CPE acquisition date (t=2.27, p=.025), lymphocyte at CPE acquisition date (t=2.01, p=.048), calcium at CPE acquisition date (t=2.68, p=.009), albumin at CPE acquisition date (t=2.29, p=.025), and creatinine at CPE acquisition date (t=2.24, p=.028). Multivariate Cox proportional hazard model showed that GCS at CPE acquisition date (HR=1.14, 95% CI=1.05-1.22), lymphocyte at CPE acquisition date (HR=1.05, 95% CI=1.00-1.10), and creatinine at CPE acquisition date (HR=1.25, 95% CI=1.04-1.49) were independent survival factors among medical intensive care unit patients with CPE. Conclusion: Based on the study results, it is necessary to develop nursing interventions that can aid in the management of patients with CPE and identify their effects.